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MANIFESTASI KLINIS DAN DIAGNOSIS MIGREN VESTIBULAR Sitorus, Freddy; Rida Ariarini, Ni Nengah; Tunjungsari, Dyah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 2 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i2.108

Abstract

CLINICAL MANIFESTATION AND DIAGNOSIS OF VESTIBULAR MIGRAINEABSTRACTVestibular migraine (VM) is the most common cause of recurrent spontaneous vertigo on outpatient dizziness clinics. Clinical manifestation of VM is highly variable. Patient may present symptoms like vertigo, dizziness, tinnitus, visual disturbance, phonophobia, photophobia, aural fullness, paresthesia, nausea, and vomiting. Most VM patients have normal physical examination between attacks. Diagnostic criteria of this disease based on joint consensus of the International Headache Society (IHS) together the Barany Society published in 2012. The Differential diagnosis of this disease are benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and acute ischemic attack. Moreover, vestibular migraine treatment is almost the same as for migraine.Keywords: Clinical manifestation, diagnosis, vestibular migraineABSTRAKMigren vestibular (MV) merupakan penyebab tersering vertigo spontan berulang pada pasien di poliklinik spesialis yang menangani rasa goyang. Manifestasi klinis dari migren vestibular sangat bervariasi. Pasien dapat mengeluhkan gejala seperti vertigo, pusing, tinitus, gangguan penglihatan, fonofobia, fotofobia, aural fullness, parestesi, mual, dan muntah. Pemeriksaan fisik pada pasien MV biasanya normal di antara serangan. Penegakan diagnosis penyakit ini berdasarkan konsensus bersama antara International Headache Society (IHS) dan Barany Society pada tahun 2012. Diagnosis diferensial penyakit ini adalah benign paroxysmal positional vertigo (BPPV), penyakit Meniere, dan serangan iskemik akut. Sampai saat ini, terapi untuk migren vestibular hampir sama dengan terapi migren pada umumnya.Kata kunci: Diagnosis, manifestasi klinis, migren vestibular
Tuberculoma With Visual and Vestibular Symptoms in A β-Thalassemia Patient: A Case Report Suryawijaya, Evlyne Erlyana; Ariarini, Ni Nengah Rida; Diafiri, Dinda; Dewati, Eva; Sitorus, Freddy
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10163

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which can affect the lungs (pulmonary TB) as well as other organs (extrapulmonary TB), including the central nervous system (CNS). The number of TB cases in Indonesia remains high, with 969,000 cases reported in 2021. Tuberculoma is a manifestation of TB in the CNS, presenting as an intracranial mass due to the spread of TB from other organs. It is a rare and serious form of CNS TB infection. The presence of congenital β-thalassemia adds complexity to the pathogenesis, diagnosis, and treatment of tuberculoma. Case Description: A 25-year-old female with a history of β-thalassemia HbE intermedia with a major phenotype presented with the main complaint of blurred vision in the lower right visual field. The patient also experienced vertigo, headache, and a history of seizures. Examination revealed inferior right quadrantanopia, anemia, leukopenia, and thrombocytopenia. Imaging and CSF analysis supported a diagnosis of intracranial tuberculoma. The patient was treated with anti-TB medication and intravenous dexamethasone. Discussion: Patients with thalassemia may have an increased risk of TB infection, including CNS TB. Tuberculoma involves granuloma formation in the brain, often in the meninges and cerebrum. Its manifestations vary and can include headaches and seizures. Diagnosis is based on clinical history, radiological findings, and laboratory results. The patient’s symptoms and imaging findings supported a diagnosis of tuberculoma, for which anti-TB and neurorestorative therapy was administered. Conclusions: Tuberculoma, as a manifestation of CNS TB, presents with variable and non-specific symptoms. Visual field disturbances can be one of the presenting symptoms that aid in diagnosis. Clinical, radiological, and laboratory evaluations are necessary for prompt and accurate diagnosis. Treatment involves anti-TB therapy and dexamethasone. This case highlights the importance of early diagnosis and comprehensive management of complex extrapulmonary TB infections.